Efficacy Evaluation Of Heluo Xiezhuo Prescription In The Prevention And Treatment Of Contrast-induced Nephropathy In Patients With Mild To Moderate Renal Insufficiency

Objective:The purpose of this article is to observe the effect of Heluo Xiezhuo Prescription on the incidence of Contrast-induced Nephropathy(CIN)and related indicators of renal injury in patients with mild to moderate renal insufficiency after coronary angiography,and to explore the preventive effect of this prescription on CIN,so as to provide Chinese effective medicine for the prevention of CIN.Methods:In this study,a total of 80 patients with chronic kidney disease(CKD)stage 2-3b who were scheduled to undergo coronary angiography in the Second Department of Cardiology of Qingdao Traditional Chinese Medicine Hospital were selected and randomly divided into an observation group of 40 cases and a control group of 40 cases.The control group was given hydration therapy from 12 hours before coronary angiography to 24 hours after the operation,and the observation group was given oral Heluoxiezhuo Prescription24 hours before the operation on the basis of the hydration therapy.Observe the changes in blood creatinine(Scr),urea nitrogen(BUN),cystatin C(Cys-c),estimated glomerular filtration rate(eGFR),urinary neutrophil gelatinase-related apolipoprotein(NGAL)24 hours before surgery,24 hours after surgery and 72 hours after surgery after coronary angiography in the two groups of patients,and compare the incidence of CIN between the two groups.Results:1.Comparison of CIN incidence between the two groups: 1 CIN(2.5%)occurred in the observed group and 9 CIN(22.5%)in the control group,and the incidence of CIN in the observed group was lower than that in the control group(P<0.05).2.24 hours after operation,compared with preoperative,the levels of Scr,BUN and urinary NGAL in the observation group were increased,and the eGFR was lower than preoperative,but the difference was not statistically significant(all P>0.05).Cys-C level was increased,with significant differences(P <0.05);the levels of Scr,BUN,Cys-C,and urinary NGAL in the control group were significantly increased,and the eGFR was significantly lower than that before operation,and the differences were statistically significant(all P<0.01).Postoperative comparison between the two groups:postoperative Scr,Cys-C and urinary NGAL levels in the observation group were lower than those in the control group,eGFR levels were higher than those in the control group,the differences were statistically significant(P< 0.05),and BUN level was lower than those in the control group,the difference was statistically significant(P<0.01).3.72 hours after operation,compared with preoperative,there was no significant change in Scr,BUN,Cys-C,urinary NGAL and eGFR in the observation group,and the difference was not statistically significant(all P>0.05).Scr,BUN,Cys-C,and urinary NGAL levels in the Control group were higher than preoperative levels,and the difference was statistical significant(P<0.05),eGFR was significantly lower than preoperative levels,and the difference was statistical significant(P<0.01).Postoperative comparison between the two groups: postoperative Scr,BUN and urinary NGAL levels in the observation group were lower than those in the control group,eGFR levels were higher than those in the control group,the differences were statistically significant(P<0.05),and the Cys-C level was significantly lower than the control group,the difference was statistically significant(P<0.01).Conclusion:Heluo Xiezhuo Prescription can significantly reduce renal function injury after coronary angiography in patients with mild to moderate renal insufficiency,reduce the incidence of CIN,and shorten the recovery time of renal injury.It is an effective prescription to prevent contrast agent nephropathy after coronary angiography in patients with mild to moderate renal insufficiency.